It’s tempting. I’ve been there. You hit a rough patch with your psychiatrist and you think, “I’m outta here.” There may be some things you can do to not only get your relationship back on track but also give it a turbo boost. I want to explore just a few of the things we can do to improve our relationships with our doctors.
First some basic facts. Psychiatry is a rare discipline of medicine and the population of psychiatrists is aging and not being replaced quickly enough by younger physicians. There are many areas of the country, small town and rural particularly, that have few to no psychiatrists. Some of us get our psychiatric care from a clinic or public health facility. Our choices are limited in these settings also.
Maybe you’ve heard of the phrase “doctor hopping.” That’s when we bounce from one psychiatrist to another looking for our perfect match. The problem with doctor hopping is that many of us don’t have a lot of options to jump to. Also, doctor hopping destroys our continuity of care and puts us at risk for relapse and misdiagnosis.
What if I told you that we can create the match we want with our current doctors? No, I don’t have a magic wand, but I do have some ideas you can try that may empower you.
Our relationships with our psychiatrists are exactly that, relationships. We are 50% of the partnership, and our psychiatrists are the other 50%. We are a team with the goal being the best mental health possible given our illnesses. The question becomes, how do we become team players?
In a word: communication. Our psychiatrists are only as good as the information we give them. Unlike other medical disciplines which can rely on MRIs, CT scans, blood tests, or surgical procedures to make diagnoses, psychiatrists rely heavily on the information we share with them. The better the information we give, the better our psychiatrists can diagnose us and treat us. If we don’t share it, they can’t know it.
One way we can improve the quality of communication with our doctors is to be prepared. We don’t have a lot of time with our psychiatrists. Unlike our therapists with whom we have, typically, an hour with weekly, with our doctors we have maybe 15 minutes monthly if that much. It’s super important then that we walk into our doctor’s office prepared to discuss our most urgent concerns. I don’t know about you, but I’m so conscious of how little time I have to speak that I sometimes leave out extremely important pieces of information I need him to know. That means I have to play catch-up. I either have to call him, write to him, or wait another month (or longer) for my next appointment. The result, I don’t get what I need from him and my care suffers.
So, what are some strategies for this particular communication problem? One solution is to write down bullet points of key concerns. Maybe you think you are having a side effect from one of your meds. Write the side effect down and the drug you are concerned about. Maybe you have a new or worsening symptom. Put it on your list and give a couple of examples. For example, maybe your anxiety is worse. Write that down and list two specific ways you feel your anxiety has worsened. If you can’t describe it, talk to your therapist about how to describe new symptoms then write them down. Maybe you’ve had a new life event that has affected symptoms. In a few sentences, describe the event. If you are afraid you won’t remember, read it to him right off the paper. When the appointment is over, all too soon, ask him if he wants the notes. He may.
A second strategy for good communication: ask your doctor to write any new diagnoses or med instructions down for you. There is no harm in bringing a notebook to write in. That way you have a record to refer to if you forget what he’s said.
If you disagree with him or you have too many symptoms and not enough time, write him a letter after your session. Letters are great because you can think through what you want to say and you have time to say exactly what you mean. He’ll most likely put the letter in your file so that when you next see him, you’ll have time to discuss. If the disagreement is intense or you are too impaired to write, consider having your therapist or other clinical support person call him and get clarification. I’m a firm believer that if our therapists and psychiatrists talked to each other more often, communication would vastly improve. That means our quality of care would improve as well.
The take-aways: we are in a relationship of healing with our MDs. Communication makes or breaks that relationship. We can learn to be better communicators. We will get better care sharing clear information.